To Determine Outcome of Lumboperitoneal Shunt in Patients of Normal Pressure Hydrocephalus

The patient presenting with gait disturbance, cognitive decline, or urinary incontinence represents a common cli-nical dilemma for the practicing neurologist and neurosurgeon. Although these symptoms are suggestive of normal pressure hydrocephalus (NPH), they are not specific to the diagnosis and commonly occur in neuro-degenerative conditions or nonspecifically in advanced age. A lumbar peritoneal (LP) shunt is a technique of cerebrospinal fluid (CSF) diversion from the lumbar thecal sac to the peritoneal cavity. It is indicated under a large number of conditions such as communicating hydrocephalus, idiopathic intracranial hypertension and normal pressure hydrocephalus.Objective: The objective of the study is to determine outcome of lumboperitoneal shunt in patients of normal pressure hydrocephalus.Study Design: Case series study.Place and Duration of Study: This study was conducted from December 19, 2012 to June 18, 2013 in the department of neurosurgery, Bahawal Victoria Hospital Bahawalpur.Subject and Methods: 96 patients of normal pressure hydrocephalus, admitted in neurosurgery ward BVH Bahawalpur were included in the study. LP shunt procedure was done under general anesthesia. 3 weeks after operation complete clinical examination, urodynamic study and CT scan brain was done to see outcome of LP shunt.Results: Total 96 patients were included in our study. The mean age of patients was 67.43 years with standard deviation of 5.395 years. Out of 96 patients, 47 (48.96%) were female and 49 (51.04%) patients were male. Out of 96 patients, 81 (84.38%) patients showed improved gait and 15 (15.62%) patients showed no improvement. Out of 96 patients, 49 patients showed improvement in incontinence while 47 patients showed no improvement. Out of 96 patients, 53 patients showed improvement in memory while 43 patients showed no improvement in memory.Conclusion: Lumboperitoneal shunt placement is a safe and effective shunting for normal pressure hydro-cephalus, resulting in significant symptomatic improvement with a low risk of over-drainage